Facility Evaluation Report

On 05/06/24 at 1pm Licensing program analyst (LPA) Villegas conducted a case management visit to issue deficiency for reporting requirements, LPA Met with Administrator Shalani Ramos as the purpose of todays visit was explained.

On 04/30/24 LPA received two unusual incident reports, the first incident report was dated 04/17/24 but was not received by the department until 04/30/24 (13 days). The second unusual incident report was dated 04/19/24 but was not received by the department until 04/30/24 (11 days). Based of review of the incident reports the facility staff did not submit the unusual incident reports within 7 days of the occurrence as required by title 22.

Deficiency cited under California code regulations, title 22, division 6, Chapter 8 are being cited on the attached LIC 809D.

Exit interview conducted, appeal rights provided, and a copy of this report was provided to